1981, 07-15 Permit: 81A-6996 PoolPLAN NUMBER •_ ,y
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOBDDRESS
WL 171
LOT
BLO K
SUBDIVISION I
e90TLl\J
LEGAL DESCRIPTION - SEE ATTACHED
3.
4.
5.
6.
OWNER
ni K
AD RES
CO RACTOR
I )1/ 11:2/6
' �v
ADDRESS
r—(�" K 14 -7c G
DESIGNER
PHO�E
. 741
IP
PARCEL NUMBER/S ort r.
PHONE
Actual Set Backs in Feet
North & 'South
Size of Parcel
?7 7c 00
Typonst. Oc upancy
Nr;
East (West
Zo lassificat on
Spri klered
❑Yes 0 N El Req'd.
PHONE
Valuation
ADDRESS
CHANGE OF USE FROM
ZIP
TO
,
� Je Building Area i� q. Ft.
a�/
r
4—O CfJj"Q
Main Floor pper Floors Garage Area
Area of Decks
Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
n‹./EW
❑ BLD.
❑ ALT.
❑ PLMB.
DESCRI9E WpR
8. Illif
I)46
9.
VALUATION
96°C)
S URCE
OF
UTILITIES
0 AD'N. ❑ RPL.
El MECH. 0 M.N.
P/❑ PO E.
POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd,
OG -4/
/
Xs7
Enum. Dist, I Location (Area)
AS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 62/
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulatinconstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env .Ith
Planning
7/43
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
r
0
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech-
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PEE -:MIT NWMRER
8 i tit c0c,600
02* *2500
* 2500 tri
* 25.0.06
A *0.00
693.72
07-13-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0171-II5.78'1
DATE ISSUED
699.65
PERMIT NO.
*25.000- —
TOTAL
9S; 'pe,t,e'd8s3-c5-`t
.,t92-01.- a► �,,, pr A D 9
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.----7w oAl SSS /et clec-
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tt
5rcr'-
V
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co.yae?g--- °fie -s'1'
plus Jv—1';+// ow
"1,: 111
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